DHSK fails to get its directives on PAC executed by CMOs in Kashmir

Irfan Tramboo

Srinagar, Feb 2: Call it inaction or the absence of a followup process, the Directorate of Health Services Kashmir (DHSK) has failed to get its directives issued to Chief Medical Officers (CMOs) across the Valley implemented. The directives sought the nomination of Nodal Officers and the Constitution of district-level Prescription Audit Committees (PAC) in District and Sub District Hospitals.
The directives were issued in January last year and even after the passage of one year, the CMOs have not taken measures for the implementation of the instructions, preferring inaction, with the concerned authorities also failing in keeping a proper follow-up of the matter.
After one year, the DHSK has woken up to the non-implementation of its circular directives by warning of strict action in case of non-compliance, noting that the medical superintendents and the administrators will be personally responsible in case the directives were not implemented “this time.”
In a circular which has been now issued by the authorities, it has been stated that “the circular instructions are not being complied with by the Chief Medical Officers & Medical Superintendents, which has been viewed seriously. It is, therefore, again enjoined upon to adhere to the instructions.”
In accordance with earlier instructions given to the CMOs and Medical Superintendents of the Kashmir Division, they were asked to designate one Nodal Officer for each District Hospital and each Sub-District Hospital of their respective Districts, who shall collect photocopies of at least 1% (one percent) of the prescriptions written by the government doctors in OPDs on a random basis each day.
They were also instructed to form district-level PACs made up of doctors in administrative positions, but not consultants.
According to the tasks assigned, the PACs were to carefully examine the prescriptions gathered by the Nodal Officers to determine whether they were legibly written in capital letters with the name of the physician, his/her signature, and registration number; whether generic drugs were prescribed and preference was given to those drugs that are freely available in hospital supplies
The PAC was also tasked with examining whether patients are referred to private clinics or specialists without the necessity for necessary diagnostic tests or procedures, unnecessary diagnostic procedures are prescribed, and prescribed medications are in violation of the Drugs & Cosmetic Act & Regulations.
The DHSK required the PACs to prepare and submit reports every two weeks, but they never did so because these committees were never established.
However, it was mandated that the Divisional Level Prescription Audit Committee, which is already in place, create a thorough monthly report with recommendations, highlighting the most important ones for the Administrative Department to take.
As a warning and a reminder which has come after a year, the DHSK stated in the circular that: “The Medical Superintendent/ Administrator of the concerned hospital shall be personally responsible for the coordination and proper implementation of these circular instructions and shall submit a preliminary compliance report on this within a week’s time positively from the date of issuance of this circular.”
It said that if any Medical Superintendent/Administrator of the hospital is found deviating from the instructions this time, “disciplinary action shall be initiated against him/her without any further notice.”